SUMMARY:

Provides functional-level support to contracts in the use of an EPIC system. Builds, maintains updates, and/or interprets reimbursement contracts for hospital billings. Formulates and defines system scope and objectives through research and fact-finding combined with an understanding of applicable IT systems and industry requirements.

ESSENTIAL FUNCTIONS:

Aligns work to organizational objectives.

Creates and communicates status reports in accordance with departmental standards.

Updates documentation consistently, following departmental policies and procedures.

Builds payer / plan-specific contract terms, including common reimbursement methodologies and how to customize.

Tests contract builds and troubleshoots.

Re-adjudicates past claims based on updates to old contracts.

Identifies solutions to complex clinical or business directives or implementation impediments.

Provides consultative services to customers and technologists as to the workflow processes and incorporation of technology solutions.

Solves production and maintenance problems, documents processes and creates action plans delineating steps and procedures. Analyzes tasks and problems and determines the most efficient and cost-effective method of accomplishing defined requirements within a scheduled deadline. Implements and modifies test plans for information technology systems including unit and system testing.

Executes comprehensive testing plans to verify critical clinical or business outputs and system integrity.

Prepares SOWs that are complete and clearly understood, while appropriately setting customer expectations.

Documents and prioritizes issues with vendor; stays current with vendor trends, strategic plans and technology.

Schedules loading bundles and fixes with vendor, systems group and customers.

Examines techniques in use and determining appropriate changes to effect improvements, reduce costs and enhance internal operational business processes.

Demonstrates ongoing dedication to expanding clinical or business expertise and applies new skills and knowledge to TMC situations.

Adheres to TMC organizational and department-specific safety, confidentiality, values, policies and standards.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION: Bachelor's degree or an equivalent combination of relevant education and experience.

EXPERIENCE: Three (3) years of clinical or business system analyst or operational experience with EMR technology. EPIC application experience preferred.

LICENSURE OR CERTIFICATION: Must have or obtain EPIC certification in one or more relevant products or solutions within one (1) year. Resolute Hospital Billing Reimbursement Contracts Administration EPIC certification preferred.

KNOWLEDGE, SKILLS AND ABILITIES:
• Knowledge of system analysis and operating systems preferably used in a hospital setting.
• Skill in assessing needs and determining through documentation the best approach system design and issues resolution.
• Skill at problem definition and data collection by establishing facts and drawing valid conclusions.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.